Form CEM-2506 "Labor Compliance - Wage Violation" - California

What Is Form CEM-2506?

This is a legal form that was released by the California Department of Transportation - a government authority operating within California. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on October 1, 2009;
  • The latest edition provided by the California Department of Transportation;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form CEM-2506 by clicking the link below or browse more documents and templates provided by the California Department of Transportation.

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Download Form CEM-2506 "Labor Compliance - Wage Violation" - California

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LABOR COMPLIANCE - WAGE VIOLATION
CEM-2506 (REV 10/2009)
CONTRACTOR INVOLVED
PRIME
SUBCONTRACTOR
EMPLOYEE
LOCATION OF DOCUMENTS
NAME OF CONTACT
LAST KNOWN ADDRESS
PHONE NUMBER OF CONTACT
CONTRACT NUMBER
FEDERAL NUMBER
CALTRANS
CONTRACTORS
LABOR PENALTIES
HOURS ON
HOURLY RATE
DAILY TOTAL
HOURS ON
HOURLY RATE
DAILY TOTAL
DAILY TOTAL WAGES
CLASSIFICATION
DIARY
REQUIRED
REQUIRED PAY
PAYROLL
PAID
ACTUAL PAY
DUE
STATE
FED
DATE
Payroll
Actual
ST
OT
ST $
OT $
ST $
OT $
ST
OT
ST $
OT $
ST $
OT $
ST $
OT $
ST $
OT $
OT $
SUBTOTALS
SUBTOTALS
GRAND TOTAL DUE EMPLOYEE
COMMENTS
CALCULATED BY
RESTITUTION
DATE
AMOUNT
BAL. DUE
CHECK #
CHECKED BY
CONFIDENTIAL
For individuals with sensory disabilities, this document is available in alternate formats. For information, call (916) 445-1233,
ADA Notice
TTY 711, or write to Records and Forms Management, 1120 N Street, MS-89, Sacramento, CA 95814.
This document contains personal information and pursuant to Civil Code 1798.21 it
shall be kept confidential in order to protect against unauthorized disclosure.
LABOR COMPLIANCE - WAGE VIOLATION
CEM-2506 (REV 10/2009)
CONTRACTOR INVOLVED
PRIME
SUBCONTRACTOR
EMPLOYEE
LOCATION OF DOCUMENTS
NAME OF CONTACT
LAST KNOWN ADDRESS
PHONE NUMBER OF CONTACT
CONTRACT NUMBER
FEDERAL NUMBER
CALTRANS
CONTRACTORS
LABOR PENALTIES
HOURS ON
HOURLY RATE
DAILY TOTAL
HOURS ON
HOURLY RATE
DAILY TOTAL
DAILY TOTAL WAGES
CLASSIFICATION
DIARY
REQUIRED
REQUIRED PAY
PAYROLL
PAID
ACTUAL PAY
DUE
STATE
FED
DATE
Payroll
Actual
ST
OT
ST $
OT $
ST $
OT $
ST
OT
ST $
OT $
ST $
OT $
ST $
OT $
ST $
OT $
OT $
SUBTOTALS
SUBTOTALS
GRAND TOTAL DUE EMPLOYEE
COMMENTS
CALCULATED BY
RESTITUTION
DATE
AMOUNT
BAL. DUE
CHECK #
CHECKED BY
CONFIDENTIAL
For individuals with sensory disabilities, this document is available in alternate formats. For information, call (916) 445-1233,
ADA Notice
TTY 711, or write to Records and Forms Management, 1120 N Street, MS-89, Sacramento, CA 95814.
This document contains personal information and pursuant to Civil Code 1798.21 it
shall be kept confidential in order to protect against unauthorized disclosure.
LABOR COMPLIANCE - WAGE VIOLATION
CEM-2506 (REV 10/2009)
INSTRUCTIONS
General
Use this form to calculate wages due employees when wage violations are found on contractor certified payrolls.
Contractor/Employee/Contract Information Section
Contractor Involved: Type the name of the affected prime contractor and subcontractor for whom the employee works. Leave the
subcontractor's name blank if none is affected.
Employee: Type the full name of the affected employee. Include titles such as Sr. and Jr. where applicable.
Location of Documents: Type the full address of the location of the affected contractor's certified payroll records.
Name of Contact: Type the name of the prime or subcontractor's contact.
Last Known Address: Type the employee's last known address.
Phone Number of Contact: Type the phone number of the prime or subcontractor's contact.
Contract Number: Type the Caltrans contract number.
Federal Number: Type the federal-aid number if the contract is federally funded.
Calculation Section
Date: Select the applicable date of underpayment from the drop-down. If work was performed at night or on a Sunday or holiday, insert
Sunday, or on holiday for all dates listed with an asterisk.
Classification:
Payroll: Type the classification as listed on the certified payroll. If the employee was not listed on the certified payroll, leave blank.
Actual: Type the classification based on the duties the employee performed as verified by diaries. If the violation involves underpayment of
listed
with an asterisk involve travel or subsistence.
Caltrans-Hours on the Diary: List the straight-time and overtime hours as listed on the diary.
Caltrans-Hourly Rate Required: List the straight-time and overtime Total Hourly Rates required by the applicable prevailing wage
determination. Use the same date and the next row to list double-time hours in excess of overtime allowed by the determination. If the
underpayment of travel or subsistence involves a daily amount rather than hourly amount, the Total Hourly Rate should be prorated over 8
hour time.
Caltrans-Daily Required Total Pay: Cells will calculate automatically.
Contractors-Hours on Payroll: Type the straight time and overtime hours as listed on the certified payroll.
Contractors-Hourly Rate Paid: Type the combined rate of pay (Basic Hourly Rate plus Fringe Benefits) actually paid by the contractor or
subcontractor.
Contractors-Daily Required Total Pay: Cells will calculate automatically.
Labor Penalties Section
State Straight-Time Penalties: The maximum $50.00 penalty is automatically entered. To override the maximum penalty, select the
appropriate amount of recommended penalties from the drop-down or type an amount for each row based on the violation. Possible penalties
are based on Section 1775 of the California Labor Code and are listed at $0.00, $10.00, $20.00, $30.00, and $50.00 in the drop-down.
Overtime Penalties: Penalties are auto-filled and set at $25.00 per day per California Labor Code Section 1813.
Federal Penalties: Type the current federal penalty rate of $10.00.
Comments: Use this section to note any appropriate information regarding state or federal determinations and wages, night work, Sundays,
holidays, calculations, classifications, hours worked, or penalties.
Calculated By: Type the full name of the person who filled in the form.
Checked By: Type the full name of the person who checked the form for accuracy. Forms must be verified by a second Labor Compliance
Officer for accuracy.
Restitution: After receiving restitution from the contractor, type the date the check (or copy of check) was received, amount of
check, balance due (if any), and check number.
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